Acquired factor VII deficiency associated with synovial sarcoma

Background: Acquired factor VII (FVII) deficiency mostly results from liver disease or vitamin K antagonists. Isolated acquired FVII deficiency is a rare event, and only a few cases have been reported. To our knowledge, this is the first reported case of synovial sarcoma associated with FVII deficiency.

Objective: To describe our findings in a 20-year-old man, who presented with hemoptysis, weight loss, and later developed a suprascapular mass.

Methods: A review of the medical record of the patient plus a comparison with the literature was conducted.

Results: A biopsy from a suprascapular mass was made and the histopathological diagnosis of the tumor was confirmed as synovial sarcoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The FVII level was 31%. No evidence of a FVII inhibitor or inactivator was demonstrated. Prothrombin time normalized during tumor regression and FVII level was elevated to 103%.

Conclusion: Clinicians should be alert to the possible association of acquired FVII deficiency in cancer patients.